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This patient diagnosed with left breast cancer adjacent to her left nipple underwent bilateral skin sparing mastectomy and immediate tissue expander placement later converted to permanent implants with fat grafting.  She had previous breast implants which had dropped significantly.  With the reconstruction, the breast footprint was lifted using the temporary expander and acellular dermal matrix to provide structure to the lower pole.  She completed nipple reconstruction and will go on to have a permanent nipple-areola tattoo.

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